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In the last 20 years, the Republic of Maldives
has made remarkable strides in human development. Substantial progress has
been made since then in the health situation. The Tsunami of December 2004
had a major impact not only on the landscape but also on the overall
development of the country. The tsunami exposed the inherent acute
vulnerability of Maldives
to natural disasters as well as the obstacles on the road to achieving
sustainable development. The social and economic development of recent years
was undone or reversed in many islands and the resilience levels of Maldivian
people were severely tested by the enormity of the Tsunami. The people of Maldives have
now recovered from the shock and committed themselves again to live better
and safer lives.
Maldives has made considerable progress in
the achievement of the health-related Millennium Development Goals,
especially in the area of child and maternal mortality. The focus on
prevention and on the public health aspects of health service, together with
access to primary health care at the level of the individual islands remain
the main factors contributing to these achievements. Nevertheless, the
remoteness of some islands and the difficult and costly transportation makes
it a challenge to sustain these achievements in the area of child and
maternal health.
Maldives has also achieved remarkable
successes in communicable disease control. Malaria was eradicated in
1984, leprosy and filaria have been reduced to
elimination levels and tuberculosis remains under control. High
immunization coverage has ensured the low prevalence or elimination of
vaccine-preventable diseases. No transmission of the indigenous wild polio
virus has been reported since 1981 and neonatal tetanus has been eliminated.
No cases of diphtheria or pertussis (whooping
cough) have been reported. However, the real test will be to sustain these
achievements over time.
The Ministry of Health must also meet the challenge of
providing equitable services to populations scattered over many islands.The
reorganization of the health system, with the introduction of atoll hospitals
and placement of doctors at health centers, has enabled increased access to
curative services for the island communities. The logistical problems to
provide the services include infrequent transport links and high operational
costs. Providing curative services at the island level has almost doubled the
cost of health services delivery.
The Maldives
is in a period of transition in health-care financing. The government is
committed to establishing a universal health insurance scheme for its entire
population. It is envisaged that universal coverage will be achieved
over different stages of implementation, starting with the introduction of a
health insurance scheme for government employees and their dependants
sometime during 2008. Expansion of either public or private health
insurance would then cover private-sector employees and their dependants and,
subsequently, the rest of the population.
New priorities of the Ministry of Health have been
identified in the Health Master Plan 2006-2015. This and other development
policy priorities in the country’s Vision 2020 have been taken into
consideration while finalizing the CCS 2007-2011 (the previous one dated
2002). The main purpose of the CCS 2007-20011 is document is to outline
priority areas for the work of the World Health Organization in Maldives.
Eight major priority areas of work were identified based on a comprehensive
review of the epidemiological and health situation of the country involving
consultations with key stakeholders and partners in health. This process also
helped review past and current cooperation between WHO and its partners and
has provided an opportunity to look ahead at future challenges in the coming
years.
Dr J.M. Luna
WHO Representative, Maldives
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